2015 New Jersey Library Association Conference Registration Form Questions: 609-394-8032 Badge and Contact Information NAME _____________________________________________ DAYTIME PHONE _______________________________TITLE _______________________________ EMAIL _______________________________________________________________ LIBRARY/INSTITUTION _____________________________________________ Please check membership(s): NJLA NJLA Friends NJ Assn. Lib. Assistants NJASL NJLTA ACRL/nj library association outside of NJ (Members of these organizations may attend at the personal member price) Please check if you are an MLS student: Indicate school _____________________________________________________________________________ Registration Fees – Please check if you are a new NJLA member and/or new attendee Early Bird: Register by March 30 Personal member Non-member Student/Retiree/Unemployed *Preconference Monday only $ 50 $ 75 $ 25 Registration after March 30 Personal member Non-member Student/Retiree/Unemployed *Preconference Monday only $ 75 $ 100 $ 50 * Indicate Preconference The Power of Friends ESL in Libraries : Communicating with our Communities Is Your Library LGBTQI Friendly? Collection development and beyond Radical Librarianship: How Ninja Librarians are Ensuring Patrons' Electronic Privacy One Day Tues. or Wed. $ 90 Tue Wed $ 125 Tue Wed $ 35 Tue Wed Full Conference Tues. & Wed. $ 145 $ 215 $ 50 One Day Tues. or Wed. $ 115 Tue Wed $ 150 Tue Wed $ 60 Tue Wed Full Conference Tues. & Wed. $ 185 $ 255 $ 75 REGISTRATIONS POSTMARKED OR FAXED AFTER MARCH 30 AND ON-SITE WILL BE CHARGED THE REGULAR FEE Tickets for Luncheons - Please indicate choice Tuesday, April 21, 2015 Inaugural Luncheon $35 Grilled Chicken with Roasted Baby Potatoes & Green Beans Vegetable Medley Pasta topped with Marinara Sauce Dietary Restriction (specify) ______________________ Wednesday, April 22, 2015 Garden State Book Awards Luncheon $35 Pan Seared Chicken Breast in a Chardonnay Sauce with Risotto Cake, Asparagus, and Baby Carrots Vegetable Lasagna Dietary Restriction (specify) ______________________ Payment must accompany this form. Please indicate method of payment. Check payable to NJLA Voucher Credit Card - Visa MC Amex #_____________________________________________________ Name on card_______________________________________________ Exp. Date___________________ Wednesday, April 22, 2015 College and University Luncheon $35 Pan Seared Chicken Breast in a Chardonnay Sauce with Risotto Cake, Asparagus, and Baby Carrots Vegetable Lasagna Dietary Restriction (specify) ______________________ Preconference Fee $_________________________________ Conference Fee $_________________________________ Luncheons $_________________________________ TOTAL: $_________________________________ Mail: NJLA Conference Pre-Registration, New Jersey Library Association, PO Box 1534, Trenton, NJ 08607 | Fax: 609-394-8032 Refunds may be issued by contacting Melissa Lena (NJLA Office – 609-394-8032, mlena@njla.org) prior to March 30. NO REFUNDS AFTER THIS DATE. REGISTRATION MUST BE RECEIVED BY APRIL 7, 2015 OR PLEASE REGISTER ON-SITE AT THE CONFERENCE. NJLA is a New Jersey Department of Education Professional Development Provider. I will require Americans with Disabilities assistance on site My daytime phone is: (______) ____________________
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